Cisapride is a prescription medication used to ease the symptoms of severe heartburn, reflux disease, and other gastrointestinal (GI) disorders. It is a controversial drug due to its long list of potentially serious side effects and adverse interactions with other medications. Doctors consider prescribing cisapride when all other remedies for GI problems fail to improve symptoms. It is typically available in tablet and liquid solution form, and intended to be taken up to four times a day. Patients who follow their doctors' instructions for taking the drug and making smart dietary choices often find relief from their symptoms within a few weeks of treatment.
Cisapride is classified as a gastroprokinetic agent. It works by enhancing the GI tract's ability to contract regularly, thereby improving digestion and stopping the backup of acid into the stomach and esophagus. Chemically, cisapride increases the amount of the neurotransmitter acetylcholine available to the nerves that control GI contractions, allowing them to activate frequently and energetically.
A number of side effects can occur with increased acetylcholine levels in the body. Diarrhea, headache, and nausea are common when taking cisapride for the first time. With continuous use, some patients experience blurred or spotty vision, dizziness, fainting spells, and breathing difficulties. The drug can potentially cause an abnormal heart rhythm, extremely high blood pressure, or liver damage that can lead to death if not treated right away. In addition, a number of prescription and over-the-counter medications can react adversely to cisapride in the body, including antibiotics, antidepressants, and heart medications.
Due to the associated dangers, government restrictions are in place in many European countries and the United States regarding the distribution of cisapride. Doctors can obtain the drug if other, more common prescription drugs are ineffective at relieving heartburn in their patients. Specific dosage amounts are calculated based on a patient's age and overall health, but most individuals are given 10 milligram tablets or .34 ounce (10 milliliter) liquid suspensions to take four times a day, one dose before each main meal and before going to bed. Doctors typically schedule frequent checkups during the first few days of treatment to make sure their patients are tolerating the doses well.
Cisapride has been found effective at treating GI problems in animals as well as humans. Due to looser restrictions and better performance in animal clinical trials, it is more widely available as a form of veterinary medicine than as a pharmaceutical. GI obstructions in a cats, dogs, and other pets can be relieved when a veterinarian administers a very small dose of the medication either intravenously or as a dissolving oral tablet.